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Engel RM, Gonski P, Vemulpad S, Graham PL. The Long-Term Benefit of Exercise With and Without Manual Therapy for Mild Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial. J Cardiopulm Rehabil Prev 2024; 44:257-265. [PMID: 38870023 DOI: 10.1097/hcr.0000000000000871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
PURPOSE Chronic obstructive pulmonary disease (COPD) is characterized by decreasing exercise capacity and deteriorating quality of life (QoL). Recent evidence indicates that combining exercise with manual therapy (MT) delivers greater improvements in exercise capacity than exercise alone in moderate COPD. The aim of this study was to investigate whether this combination delivers similar results in mild COPD. METHODS A total of 71 participants aged 50-65 yr with mild COPD were randomly allocated to two groups: exercise only (Ex) or MT plus exercise (MT + Ex). Both groups received 16 wk of exercise with the MT + Ex group also receiving 8 MT sessions. Lung function (forced vital capacity [FVC] and forced expiratory volume in the 1 st sec [FEV 1 ]), exercise capacity (6-min walk test [6MWT]), and QoL (St George's Respiratory Questionnaire [SGRQ] and Hospital Anxiety and Depression Scale [HADS]) were measured at baseline, 4, 8, 16, 24, 32, and 48 wk. RESULTS Although there was no difference in the mean effect over time between groups for lung function (FEV 1 , P = .97; FVC, P = .98), exercise capacity (6MWT, P = .98), and QoL (SGRQ, P = .41; HADS anxiety, P = .52; and HADS depression, P = .06), there were clinically meaningful improvements at 48 wk for 6MWT (30 m; 95% CI, 10-51 m; P < .001), SGRQ (6.3 units; 95% CI, 2.5-10.0; P < .001), and HADS anxiety (1.5 units; 95% CI, 0.3-2.8 units; P = .006) across the entire cohort. CONCLUSIONS While adding MT to Ex did not produce any additional benefits, exercise alone did deliver sustained modest improvements in exercise capacity and QoL in mild COPD.
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Affiliation(s)
- Roger Mark Engel
- Author Affiliations: Department of Chiropractic, Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney, Australia (Dr Engel); Southcare, Sutherland Hospital, Sydney, Australia (Associate Professor Gonski); Department of Natural Sciences, Faculty of Science and Engineering, Macquarie University, Sydney, Australia (Associate Professor Vemulpad); School of Mathematical and Physical Sciences, Faculty of Science and Engineering, Macquarie University, Sydney, Australia (Associate Professor Graham)
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Akuzum F, Senel A, Polat B, Kardes K, Aslan GK. Physiotherapy interventions on chest wall mobility in obstructive lung diseases: A systematic review. J Bodyw Mov Ther 2024; 38:368-374. [PMID: 38763581 DOI: 10.1016/j.jbmt.2023.11.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 11/14/2023] [Accepted: 11/24/2023] [Indexed: 05/21/2024]
Abstract
PURPOSE The aim of this systematic review was to investigate the effectiveness of physiotherapy interventions on chest mobility in obstructive lung diseases. METHODS Searches were performed in PEDro, Pubmed and Cochrane Central Register of Controlled Trials databases without language restrictions between 2010 and 25th December 2020. Randomized controlled trials (RCTs) investigating physiotherapy interventions on chest wall mobility were included. Two independent reviewers screened studies, extracted data, and assessed methodological quality of included studies. The assessment of risk of bias was conducted using the PEDro scale for RCTs. The articles were excluded if they have less than 5 out of 10 score. RESULTS Five studies included had good to excellent quality. A total of 139 patients were included in all RCTs. Intervention duration ranged from a single session to 12 weeks and the intervention schedules varied, consisting of 1-24 sessions, lasting 5-45 min per sessions. Three studies used respiratory muscle stretching and releasing techniques, one study combined respiratory muscle stretching with aerobic training, and one study planned diaphragmatic breathing. Four studies assessed chest wall mobility with optoelectronic plethysmography, whereas one study used measuring tape. CONCLUSIONS The result of this first systematic review that investigates the effects of physiotherapy interventions on chest wall mobility in obstructive lung diseases suggests that more and better quality RCTs with objective measurement tools are required.
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Affiliation(s)
- Funda Akuzum
- Division of Physiotherapy and Rehabilitation, Institute of Graduate Studies, Istanbul University-Cerrahpaşa, Istanbul, Turkey.
| | - Aybike Senel
- Division of Physiotherapy and Rehabilitation, Institute of Graduate Studies, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Basak Polat
- Division of Physiotherapy and Rehabilitation, Institute of Graduate Studies, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Kubra Kardes
- Division of Physiotherapy and Rehabilitation, Institute of Graduate Studies, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Goksen Kuran Aslan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpaşa, Istanbul, Turkey
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Jonely H, Jayaseelan D, Costello E, Signorino J, Wooten L, Murray D, Woolstenhulme J. Changes in pulmonary function following thoracic spine manipulation in a healthy inactive older adult population-a pilot study. J Phys Ther Sci 2023; 35:492-496. [PMID: 37405180 PMCID: PMC10315198 DOI: 10.1589/jpts.35.492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 04/03/2023] [Indexed: 07/06/2023] Open
Abstract
[Purpose] Pulmonary function pathology is primarily treated pharmacologically, with a range of medication side effects. Few studies have systematically examined non-pharmacologic approaches such as joint manipulation effects on pulmonary function. This study examined the immediate and short-term effects of thoracic manipulation on pulmonary function. [Participants and Methods] Twenty-one physically inactive otherwise healthy participants aged 50 years or older were randomly assigned to either receive three sessions of thoracic manipulation (n=10) or three sessions of "sham intercostal training" (n=11). Outcome measures included forced vital capacity, maximal voluntary ventilation and thoracic excursion during maximal inhalation and exhalation. [Results] There was a statistically significant difference in maximal voluntary ventilation in the manipulation group, when measured within a week of the third intervention session and immediate effects in thoracic excursion during exhalation in the sham group following a single intervention session. There were no significant changes in other measures. [Conclusion] Spinal manipulation had no immediate effect on pulmonary function, however, affected an improvement in maximal voluntary ventilation within 7 days following a third session. The sham intervention showed a change in thoracic excursion during exhalation after the first session. Future research is necessary to further explore the relationship between thoracic manipulation and pulmonary function.
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Affiliation(s)
- Holly Jonely
- The School of Medicine & Health Sciences, Physical
Therapy & Health Care Sciences, The George Washington University: 2000 Pennsylvania
Ave, NW, Suite 2000, Washington, DC 20006, USA
| | - Dhinu Jayaseelan
- The School of Medicine & Health Sciences, Physical
Therapy & Health Care Sciences, The George Washington University: 2000 Pennsylvania
Ave, NW, Suite 2000, Washington, DC 20006, USA
| | - Ellen Costello
- The School of Medicine & Health Sciences, Physical
Therapy & Health Care Sciences, The George Washington University: 2000 Pennsylvania
Ave, NW, Suite 2000, Washington, DC 20006, USA
| | - Joseph Signorino
- The School of Medicine & Health Sciences, Physical
Therapy & Health Care Sciences, The George Washington University: 2000 Pennsylvania
Ave, NW, Suite 2000, Washington, DC 20006, USA
- Division of Physical Therapy, Shenandoah University,
USA
| | - Liana Wooten
- Department of Public Health and Community Medicine, School
of Medicine, Doctor of Physical Therapy Program, Tufts University, USA
| | - Donal Murray
- The School of Medicine & Health Sciences, Physical
Therapy & Health Care Sciences, The George Washington University: 2000 Pennsylvania
Ave, NW, Suite 2000, Washington, DC 20006, USA
| | - Josh Woolstenhulme
- The School of Medicine & Health Sciences, Physical
Therapy & Health Care Sciences, The George Washington University: 2000 Pennsylvania
Ave, NW, Suite 2000, Washington, DC 20006, USA
- Department of Physical Therapy and Athletic Training,
Meridian Health Sciences Center, Idaho State University, USA
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Buran Cirak Y, Yilmaz Yelvar GD, Durustkan Elbasi N. Effectiveness of 12-week inspiratory muscle training with manual therapy in patients with COPD: A randomized controlled study. THE CLINICAL RESPIRATORY JOURNAL 2022; 16:317-328. [PMID: 35332685 PMCID: PMC9060133 DOI: 10.1111/crj.13486] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 02/12/2022] [Accepted: 03/08/2022] [Indexed: 12/13/2022]
Abstract
The benefits of inspiratory muscle training (IMT) in patients with COPD were reported. However, its effects are limited in severe COPD patients. Further researches are required in new and complementary modalities demonstrating IMT efficacy in severe COPD patients. This study aims to investigate effects of manual therapy (MT) additional over IMT on functional capacity, respiratory muscle strength, pulmonary function, dyspnea, fatigue, and quality of life in severe COPD patients. Sixty patients with COPD in GOLD stage III-IV were included in this prospective single-blind randomized trial. Patients were randomly assigned to receive either MT additional over IMT at 40% of maximal inspiratory pressure (MIP) (n = 30) or only IMT (n = 30) for 12 weeks. MT group received MT during 12 weeks for 30 min additional to IMT. Pulmonary function, respiratory muscle strength, functional capacity, dyspnea, fatigue, and quality of life were evaluated by spirometry, mouth pressure device, six-minute walk test, Modified Medical Research Council (mMRC) dyspnea scale, fatigue severity scale, and St. George's Respiratory Questionnaire (SGRQ), respectively. MT group had significantly greater improvement in FEV1%, FVC%, PEF%, respiratory muscle strength, function, dyspnea, fatigue, and quality of life compared with IMT group (p < 0.05). 6MWT (p < 0.001, effect size Cohen's d: 0.915), MIP (p < 0.001, effect size Cohen's d: 1.235), and mMRC score (p < 0.001, effect size Cohen's d: 0.982) were significantly improved in IMT with MT group. This study demonstrated that subjects in IMT with MT group had improved outcomes in functional capacity, respiratory muscle strength, pulmonary function, dyspnea, fatigue perception, and quality of life compared with alone IMT group.
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Affiliation(s)
- Yasemin Buran Cirak
- Physiotherapy and Rehabilitation Department, Faculty of Health Science, Istinye University, Istanbul, Turkey
| | - Gul Deniz Yilmaz Yelvar
- Physiotherapy and Rehabilitation Department, Faculty of Health Science, Istinye University, Istanbul, Turkey
| | - Nurgül Durustkan Elbasi
- Physiotherapy and Rehabilitation Department, Faculty of Health Science, Istinye University, Istanbul, Turkey
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Kim KI, Lee BJ, Jung HJ. The effectiveness and safety of Chuna manual therapy adjuvant to Western medicine in patients with chronic obstructive pulmonary disease: Study protocol for a randomized, single-blind, investigator-initiated, pilot trial. Medicine (Baltimore) 2021; 100:e27217. [PMID: 34559113 PMCID: PMC10545039 DOI: 10.1097/md.0000000000027217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 08/27/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND In chronic obstructive pulmonary disease (COPD) management, greater emphasis has been placed on symptomatic improvement and enhanced quality of life in patients. Manual therapy among respiratory rehabilitation programs has received much attention recently, with the publication of numerous studies. In South Korea, a method known as Chuna Manual Therapy (CMT) has been applied in the management of COPD patients and in clinical practice, but the clinical basis for safety and effectiveness is yet to be established. Therefore, rigorously designed randomized controlled trials are required. We aimed to evaluate the feasibility of assessing the add-on effect and safety of CMT administered with standard Western medicine therapy for the treatment of COPD. METHODS This is a randomized, single-blind, single-center clinical pilot trial. Patients with COPD receiving standard drug therapy are randomly divided into an experimental group (n = 20) and a control group (n = 20) at a 1:1 ratio. The experimental group receives CMT adding to the standard medical therapy once a week for 8 weeks. The control group receives only the standard drug treatment. The trial is conducted with an outcome assessor and statistician blinding. The primary outcome is the 6-minute walk test. The secondary outcomes include the pulmonary function test, the Modified Medical Research Council, visual analog scale for dyspnea, COPD assessment test, quality of life using the St. George's respiratory questionnaire, EuroQOL five dimensions questionnaire, and Korean pattern identification questionnaire. Adverse events are also be evaluated. CONCLUSIONS The results of this study will provide the feasibility of a large-scale clinical trial to establish high-quality clinical evidence of CMT for COPD. TRIAL REGISTRATION Korean Clinical Trial Registry (http://cris.nih.go.kr; registration number: KCT0006119).
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Affiliation(s)
- Kwan-Il Kim
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Dongdaemun-gu, Seoul, Republic of Korea
- Division of Allergy, Immune and Respiratory System, Department of Internal Korean Medicine, Kyung Hee University, Dongdaemun-gu, Republic of Korea
| | - Beom-Joon Lee
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Dongdaemun-gu, Seoul, Republic of Korea
- Division of Allergy, Immune and Respiratory System, Department of Internal Korean Medicine, Kyung Hee University, Dongdaemun-gu, Republic of Korea
| | - Hee-Jae Jung
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Dongdaemun-gu, Seoul, Republic of Korea
- Division of Allergy, Immune and Respiratory System, Department of Internal Korean Medicine, Kyung Hee University, Dongdaemun-gu, Republic of Korea
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Kwon CY, Lee B, Lee BJ, Kim KI, Jung HJ. Comparative Effectiveness of Western and Eastern Manual Therapies for Chronic Obstructive Pulmonary Disease: A Systematic Review and Network Meta-Analysis. Healthcare (Basel) 2021; 9:healthcare9091127. [PMID: 34574903 PMCID: PMC8467771 DOI: 10.3390/healthcare9091127] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/21/2021] [Accepted: 08/25/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Manual therapy (MT) is considered a promising adjuvant therapy for chronic obstructive pulmonary disease (COPD). Comparing the effectiveness among different Western and Eastern MTs being used for the management of COPD could potentially facilitate individualized management of COPD. This systematic review attempted to estimate the comparative effectiveness of Western and Eastern MTs for COPD patients using a network meta-analysis (NMA) methodology. Methods: Nine electronic databases were comprehensively searched for relevant randomized controlled trials (RCTs) published up to February 2021. Pair-wise meta-analysis and NMA were conducted on the outcomes of COPD, which included lung function and exercise capacity. Results: The NMA results from 30 included RCTs indicated that the optimal treatment for each outcome according to the surface under the cumulative ranking curve was massage, acupressure, massage, and tuina for forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC, and 6 min walking distance, respectively. Conclusions: MTs such as massage, acupressure, and tuina have shown comparative benefits for lung function and exercise capacity in COPD. However, the methodological quality of the included studies was poor, and the head-to-head trial comparing the effects of different types of MTs for COPD patients was insufficient. Therefore, further high-quality RCTs are essential.
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Affiliation(s)
- Chan-Young Kwon
- Department of Oriental Neuropsychiatry, Dong-eui University College of Korean Medicine, Busan 47227, Korea;
| | - Boram Lee
- Clinical Research Coordinating Team, Korea Institute of Oriental Medicine, Seoul 02447, Korea;
| | - Beom-Joon Lee
- Department of Internal Korean Medicine, Kyung Hee University Korean Medicine Hospital, Seoul 02453, Korea;
- Division of Allergy, Immune and Respiratory System, Department of Internal Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02447, Korea
| | - Kwan-Il Kim
- Department of Internal Korean Medicine, Kyung Hee University Korean Medicine Hospital, Seoul 02453, Korea;
- Division of Allergy, Immune and Respiratory System, Department of Internal Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02447, Korea
- Correspondence: (K.-I.K.); (H.-J.J.); Tel.: +82-2-958-9124 (K.-I.K.); +82-2-958-9147 (H.-J.J.)
| | - Hee-Jae Jung
- Department of Internal Korean Medicine, Kyung Hee University Korean Medicine Hospital, Seoul 02453, Korea;
- Division of Allergy, Immune and Respiratory System, Department of Internal Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02447, Korea
- Correspondence: (K.-I.K.); (H.-J.J.); Tel.: +82-2-958-9124 (K.-I.K.); +82-2-958-9147 (H.-J.J.)
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Perceptions and experiences of a manual therapy trial: a qualitative study of people with moderate to severe COPD. Chiropr Man Therap 2021; 29:27. [PMID: 34315527 PMCID: PMC8314605 DOI: 10.1186/s12998-021-00387-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/07/2021] [Indexed: 11/22/2022] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) presents with physical, emotional and social difficulties that affect quality of life. Multimodal management includes both pharmacological and non-pharmacological strategies, and pulmonary rehabilitation (PR) plays an important role. Recent research has suggested that manual therapies may improve perceptions of dyspnea for people with COPD. Methods Focus group interviews were conducted as part of a mixed methods study to assess the feasibility of implementing a manual therapy technique—muscle energy technique (MET)—as an adjunct to PR for people with moderate to severe COPD. Focus group interviews were conducted to examine trial participants views of the intervention and the trial design. A thematic analysis was undertaken to explore the data. Results Twelve participants with moderate to severe COPD participated in three focus groups. Participants were motivated to participate in the trial to be proactive about their health. They perceived MET to be a gentle, comfortable form of stretching that allowed them to ‘breathe easier’ and prepared them for PR. A small number of participants reported mild muscular discomfort during MET, but this was short-lasting and was not bothersome. Participants enjoyed the one-on-one contact with researchers and learned more about their breathing while performing spirometric testing. Most participants wanted longer and more frequent MET sessions, and some requested ‘homework’ stretching exercises. Conclusions The findings of this study show that a manual therapy intervention was received well by participants in a clinical trial setting. A small number of participants reported mild musculoskeletal discomfort in relation to the MET treatment. Participant preferences for additional and longer treatment sessions should be carefully considered against available resources in future clinical trials. Trial registration ANZCTR, ACTRN12618000801213. Registered 11 May 2018 - Retrospectively registered. http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374643&isReview=true Supplementary Information The online version contains supplementary material available at 10.1186/s12998-021-00387-0.
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Roh JA, Kim KI, Jung HJ. The efficacy of manual therapy for chronic obstructive pulmonary disease: A systematic review. PLoS One 2021; 16:e0251291. [PMID: 34003822 PMCID: PMC8130973 DOI: 10.1371/journal.pone.0251291] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 04/25/2021] [Indexed: 11/18/2022] Open
Abstract
Background Manual therapy (MT) can be beneficial in the management of chronic obstructive pulmonary disease (COPD). However, evidence of the efficacy of MT for COPD is not clear. Therefore, we aimed to review the effects of MT, including Chuna, in people diagnosed with COPD. Methods MEDLINE via PubMed, EMBASE, The Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Database (CNKI), KoreaMed, Korean Medical Database (KMbase), and Oriental Medicine Advanced Searching Integrated System (OASIS) were searched. Randomized controlled trials (RCTs) and crossover RCTs were included. The main inclusion criteria were COPD diagnosis (forced expiratory volume in the first second [FEV1]/forced vital capacity [FVC] < 0.70). The primary outcomes were lung function and exercise capacity. The secondary outcomes were symptoms, quality of life (QoL), and adverse event (AE)s. Studies reporting one or both of the primary outcomes were included. The Cochrane RoB 2.0 tool was used to assess the risk of bias. Data synthesis and analysis were conducted according to the trial design. Results Of the 2564 searched articles, 13 studies were included. For the primary outcomes, the effect of MT on pulmonary function and exercise capacity in COPD was partly significant but could not be confirmed due to the limited number of studies included in the subgroups. For the secondary outcomes, no definitive evidence regarding the improvement of symptoms and QoL was found, and some minor adverse effects were reported. Conclusions There is insufficient evidence to support the role of MT in the management of COPD. High-quality studies are needed to thoroughly evaluate the effect of MT on COPD.
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Affiliation(s)
- Ji-Ae Roh
- Department of Clinical Korean Medicine, Graduate School of Kyung Hee University, Seoul, Republic of Korea
- Division of Allergy, Department of Internal Medicine, Immune and Respiratory System, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Kwan-Il Kim
- Department of Clinical Korean Medicine, Graduate School of Kyung Hee University, Seoul, Republic of Korea
- Division of Allergy, Department of Internal Medicine, Immune and Respiratory System, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
- * E-mail: (KIK); (HJJ)
| | - Hee-Jae Jung
- Department of Clinical Korean Medicine, Graduate School of Kyung Hee University, Seoul, Republic of Korea
- Division of Allergy, Department of Internal Medicine, Immune and Respiratory System, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
- * E-mail: (KIK); (HJJ)
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Hinkeldey N, Okamoto C, Khan J. Spinal Manipulation and Select Manual Therapies: Current Perspectives. Phys Med Rehabil Clin N Am 2020; 31:593-608. [PMID: 32981581 DOI: 10.1016/j.pmr.2020.07.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Touch is fundamental to the doctor-patient relationship. Touch can produce neuromodulatory effects that mitigate pain and put patients at ease. Touch begins with a confident handshake and continues throughout the physical examination. Touching patients where they hurt is a clear indication that a provider understands their complaint. Touch often continues as a function of treatment. This article updates evidence surrounding human touch and addresses mechanisms of action for manual therapy, the impact of manual therapy on pain management, health care conditions for which manual therapy may be beneficial, treatment plans with dose-response evidence, and the impact of manual therapy on the health care system.
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Affiliation(s)
- Nathan Hinkeldey
- VA Central Iowa Health Care System, 3600 30th Street, Des Moines, IA 50310, USA; Palmer College of Chiropractic, 1000 Brady Street, Davenport, IA 52803, USA.
| | - Casey Okamoto
- Minneapolis VA Health Care System, 1 Veterans Drive, Minneapolis, MN 55417, USA; Department of Rehabilitation Medicine, 500 Boynton Health Service Bridge, Minneapolis, MN 55455, USA
| | - Jamal Khan
- Minneapolis VA Health Care System, 1 Veterans Drive, Minneapolis, MN 55417, USA; Department of Rehabilitation Medicine, 500 Boynton Health Service Bridge, Minneapolis, MN 55455, USA
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Roh JA, Kim KI, Park J, Lee BJ, Jung HJ. The efficacy of manual therapy (Chuna) for chronic obstructive pulmonary disease: Protocol for a systematic review. Medicine (Baltimore) 2020; 99:e18832. [PMID: 32118706 PMCID: PMC7478514 DOI: 10.1097/md.0000000000018832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 12/19/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a challenging disease whose prevalence has increased over the last decades. Non-pharmacological therapies such as pulmonary rehabilitation occupy a core position in patient management. Among these therapies, manual therapy reduces symptoms and increases exercise capacity targeting musculoskeletal problems. Chuna, a traditional Korean manual therapy, has improved pulmonary disorders in clinical practice but unfortunately has not had its effects reported. This systematic review aims to evaluate the effectiveness and safety of manual therapy, focused on the use of Chuna in the management of COPD patients. METHODS The following databases will be used in this study: MEDLINE via PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Database (CNKI), KoreaMed, Korean Medical Database (KMbase), and Oriental Medicine Advanced Searching Integrated System (OASIS). The primary outcome comprises lung function and exercise capacity. Secondary outcomes included symptoms, quality of life, and adverse events. We will include randomized controlled trials (RCTs) and crossover studies. Two independent reviewers will screen the searched studies, determine if they are suitable for inclusion, and perform data extraction. The risk of bias will be assessed using the Cochrane risk of bias tool. When appropriate, data will be pooled across studies for meta-analysis using a fixed or random effects model. When quantitative synthesis is not appropriate, the evidence will be summarized qualitatively. RESULTS This study will provide a comprehensive review of the available evidence to assess the efficacy of Chuna for COPD patients. Results will be published in a peer-reviewed journal and disseminated electronically and in print. CONCLUSIONS This study will provide high-quality current evidence for evaluation the efficacy of Chuna for patients with COPD. Clinicians, patients and policy makers may find this review useful in making decisions regarding the use of Chuna for patients with COPD. PROSPERO REGISTRATION NUMBER CRD42019141150.
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Affiliation(s)
- Ji-Ae Roh
- Department of Clinical Korean Medicine
- Division of Allergy, Immune and Respiratory System, Department of Internal Medicine, College of Korean Medicine
| | - Kwan-Il Kim
- Department of Clinical Korean Medicine
- Division of Allergy, Immune and Respiratory System, Department of Internal Medicine, College of Korean Medicine
| | - Jihye Park
- Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Dongdaemun-gu, Seoul, Republic of Korea
| | - Beom-Joon Lee
- Department of Clinical Korean Medicine
- Division of Allergy, Immune and Respiratory System, Department of Internal Medicine, College of Korean Medicine
| | - Hee-Jae Jung
- Department of Clinical Korean Medicine
- Division of Allergy, Immune and Respiratory System, Department of Internal Medicine, College of Korean Medicine
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Baxter DA, Shergis JL, Fazalbhoy A, Coyle ME. Muscle energy technique for chronic obstructive pulmonary disease: a systematic review. Chiropr Man Therap 2019; 27:37. [PMID: 31452871 PMCID: PMC6700764 DOI: 10.1186/s12998-019-0256-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 05/10/2019] [Indexed: 11/24/2022] Open
Abstract
Background Chronic Obstructive Pulmonary Disease (COPD) is an increasingly prevalent respiratory disease that impacts on daily living. In addition to difficulty breathing, many people experience extrapulmonary comorbidities such as musculoskeletal disorders. Pulmonary rehabilitation can improve fitness and strength but may be difficult for patients with musculoskeletal disorders. Recent research indicates promising benefits of adding manual therapy to standard care to improve clinical outcomes. Objectives To evaluate the efficacy and safety of Muscle Energy Technique (MET) for people with COPD. Methods Ten databases were searched from inceptions to May 2018. Eligible studies were randomised controlled trials assessing MET compared to any control for COPD. Outcomes included lung function, exercise capacity, health-related quality of life, and adverse events. Results Three randomised controlled trials assessing 90 participants were included. The quality of the research was limited by reporting of outcome measures and results, varying treatment protocols, and small sample sizes. Results from one study showed that pulmonary function was not statistically different between groups at end of treatment (FEV1% MD 4.87%; 95% CI - 0.79 to 10.53). Exercise capacity and perceived dyspnoea ratings were improved in single studies. Adverse events were unrelated to the MET intervention. Conclusions The use of MET for COPD is an emerging field of research, with few studies evaluating its efficacy and safety. Currently, there is insufficient evidence to support the use of MET in the management of COPD. Rigorously designed studies with larger sample sizes are needed to better understand the role of MET for COPD.
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Affiliation(s)
- Danielle A. Baxter
- School of Health and Biomedical Sciences, RMIT University, PO Box 71, Bundoora, VIC 3083 Australia
| | - Johannah L. Shergis
- School of Health and Biomedical Sciences, RMIT University, PO Box 71, Bundoora, VIC 3083 Australia
| | - Azharuddin Fazalbhoy
- School of Health and Biomedical Sciences, RMIT University, PO Box 71, Bundoora, VIC 3083 Australia
| | - Meaghan E. Coyle
- School of Health and Biomedical Sciences, RMIT University, PO Box 71, Bundoora, VIC 3083 Australia
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Simonelli C, Vitacca M, Vignoni M, Ambrosino N, Paneroni M. Effectiveness of manual therapy in COPD: A systematic review of randomised controlled trials. Pulmonology 2019; 25:236-247. [PMID: 30738792 DOI: 10.1016/j.pulmoe.2018.12.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 11/20/2018] [Accepted: 12/15/2018] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Manual therapy (MT) has been proposed in pulmonary rehabilitation programmes for patients with chronic obstructive pulmonary disease (COPD), but an updated systematic review of the evidence is lacking. We aimed to systematically review the effectiveness of MT interventions, alone or added to exercise, on lung function, exercise capacity and quality of life in COPD patients, compared to other therapies (e.g. exercise alone) or no treatment. MATERIALS AND METHODS We searched MEDLINE, EMBASE, Physiotherapy Evidence Database, and Cochrane Central Register of Controlled Trials databases, using the terms: COPD, manual therapy, manipulation, joint mobilisation, osteopathic manipulation. Only randomised controlled trials (RCT) were considered. RESULTS Out of 555 articles screened, 6 fulfilled the inclusion criteria. The study designs were heterogeneous (with different intervention schedules) and there was a high risk of bias. No effect on lung function was found, while results on exercise capacity were contrasting. MT had no effect on quality of life, although valid measures were available only in one study. Only mild adverse events were reported. CONCLUSIONS Few RCTs of poor methodological quality are available on the effects of MT in COPD. More and better quality RCTs are needed before this technique can be included in rehabilitation programmes for these patients.
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Affiliation(s)
- C Simonelli
- Istituti Clinici Scientifici Maugeri IRCCS, Cardiac Rehabilitation of the Institute of Lumezzane (BS), Italy.
| | - M Vitacca
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Lumezzane (BS), Italy
| | - M Vignoni
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Montescano (PV), Italy
| | - N Ambrosino
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Montescano (PV), Italy
| | - M Paneroni
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Lumezzane (BS), Italy
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Liem T. Osteopathic Manipulative Treatment for Pertussis in the 19th and 20th Centuries: A Structured Historical Literature Review. J Osteopath Med 2019; 119:116-125. [PMID: 30688349 DOI: 10.7556/jaoa.2019.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background Cases of pertussis, or whooping cough, have increased in recent years despite widespread vaccination and adequate antibiotic treatments. Osteopathic physicians may want to consider using osteopathic manipulative treatment (OMT) as an adjunctive treatment modality for pertussis; however, suitable OMT techniques are not specified in the research literature. Objective To search the historical osteopathic literature to identify OMT techniques that were used in the management of pertussis in the pre-antibiotic era. Methods A structured literature review of electronic databases and historical osteopathic journals and books was conducted. Included were information on OMT techniques used for patients with pertussis. Results The 24 identified sources included 8 articles and 16 book contributions from the years 1886 to 1958. Most sources were published within the first quarter of the 20th century. Commonly identified OMT techniques included mobilization techniques, lymphatic pump techniques, and other manipulative techniques predominantly in the cervical and thoracic regions. Conclusion The wealth of OMT techniques for patients with pertussis that were identified suggests that pertussis was commonly treated by early osteopaths. Further research is necessary to identify or establish the evidence base for these techniques so that in case of favorable outcomes, their use by osteopathic physicians is justified as adjunctive modalities when encountering a patient with pertussis.
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Mancini D, Cesari M, Lunghi C, Benigni AM, Antonelli Incalzi R, Scarlata S. Ultrasound Evaluation of Diaphragmatic Mobility and Contractility After Osteopathic Manipulative Techniques in Healthy Volunteers: A Prospective, Randomized, Double-Blinded Clinical Trial. J Manipulative Physiol Ther 2019; 42:47-54. [DOI: 10.1016/j.jmpt.2018.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 06/06/2018] [Accepted: 08/16/2018] [Indexed: 10/27/2022]
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15
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Effects of manual therapy on the diaphragm in asthmatic patients: A randomized pilot study. INT J OSTEOPATH MED 2018. [DOI: 10.1016/j.ijosm.2018.07.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Galletti J, Mcheileh G, Hahne A, Lee AL. The Clinical Effects of Manipulative Therapy in People with Chronic Obstructive Pulmonary Disease. J Altern Complement Med 2018; 24:677-683. [PMID: 29595991 DOI: 10.1089/acm.2017.0390] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study aimed to determine the effects of manipulative therapies (MT), including spinal manipulation, and diaphragmatic release techniques on lung function, exercise capacity, symptoms, and health-related quality of life (HRQOL) in people with chronic obstructive pulmonary disease (COPD). DESIGN Systematic review. PARTICIPANTS People diagnosed with COPD. INTERVENTION Randomized controlled trials of MT (either with or without pulmonary rehabilitation [PR]) compared to other treatments (soft tissue [ST] therapy or sham therapy) applied in people with COPD were identified following the search of seven databases. Two reviewers independently assessed study quality and extracted data. OUTCOME MEASURES Lung function, exercise capacity, symptoms, and HRQOL. RESULTS Four studies were included, with a total of 68 participants. The heterogeneity between treatments prevented meta-analysis. There was no beneficial effect on spirometry measures of lung function with MT. MT combined with PR improved exercise capacity by 48-49 m more than ST therapy plus PR. Less dyspnea was reported with MT and ST therapy compared to ST therapy alone (p = 0.01), but there was no effect on HRQOL, or symptoms of anxiety or depression. CONCLUSIONS In people with COPD, MT (either with or without PR) improved functional exercise capacity, but had no effect on lung function, or HRQOL. Further research is required to determine the underlying mechanism of this treatment approach and its relationship to exercise capacity.
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Affiliation(s)
- Jayde Galletti
- 1 Department of Physiotherapy, Rehabilitation, Nutrition and Sport, La Trobe University , Bundoora, Australia
| | - George Mcheileh
- 1 Department of Physiotherapy, Rehabilitation, Nutrition and Sport, La Trobe University , Bundoora, Australia
| | - Andrew Hahne
- 1 Department of Physiotherapy, Rehabilitation, Nutrition and Sport, La Trobe University , Bundoora, Australia
| | - Annemarie Louise Lee
- 1 Department of Physiotherapy, Rehabilitation, Nutrition and Sport, La Trobe University , Bundoora, Australia .,2 Institute for Breathing and Sleep , Austin Health, Heidelberg, Australia .,3 Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, School of Primary and Allied Health Care, Monash University , Frankston, Australia
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López-de-Uralde-Villanueva I, Candelas-Fernández P, de-Diego-Cano B, Mínguez-Calzada O, Del Corral T. The effectiveness of combining inspiratory muscle training with manual therapy and a therapeutic exercise program on maximum inspiratory pressure in adults with asthma: a randomized clinical trial. Clin Rehabil 2018; 32:752-765. [PMID: 29318917 DOI: 10.1177/0269215517751587] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate whether the addition of manual therapy and therapeutic exercise protocol to inspiratory muscle training was more effective in improving maximum inspiratory pressure than inspiratory muscle training in isolation. DESIGN This is a single-blinded, randomized controlled trial. SUBJECTS In total, 43 patients with asthma were included in this study. INTERVENTIONS The patients were allocated into one of the two groups: (1) inspiratory muscle training ( n = 21; 20-minute session) or (2) inspiratory muscle training (20-minute session) combined with a program of manual therapy (15-minute session) and therapeutic exercise (15-minute session; n = 22). All participants received 12 sessions, two days/week, for six weeks and performed the domiciliary exercises protocol. MAIN MEASURES The main measures such as maximum inspiratory pressure, spirometric measures, forward head posture, and thoracic kyphosis were recorded at baseline and after the treatment. RESULTS For the per-protocol analysis, between-group differences at post-intervention were observed in maximum inspiratory pressure (19.77 cmH2O (11.49-28.04), P < .05; F = 22.436; P < .001; η2p = 0.371) and forward head posture (-1.25 cm (-2.32 to -0.19), P < .05; F = 5.662; P = .022; η2p = 0.13). The intention-to-treat analysis showed the same pattern of findings. CONCLUSION The inspiratory muscle training combined with a manual therapy and therapeutic exercise program is more effective than its application in isolation for producing short-term maximum inspiratory pressure and forward head posture improvements in patients with asthma.
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Affiliation(s)
- Ibai López-de-Uralde-Villanueva
- 1 Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,2 Motion in Brains Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,3 Instituto de investigación para la salud (IdiPAZ), Hospital La Paz, Madrid, Spain
| | - Pablo Candelas-Fernández
- 1 Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Beatriz de-Diego-Cano
- 1 Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Orcález Mínguez-Calzada
- 1 Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Tamara Del Corral
- 1 Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,2 Motion in Brains Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
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Yeh GY, Horwitz R. Integrative Medicine for Respiratory Conditions: Asthma and Chronic Obstructive Pulmonary Disease. Med Clin North Am 2017; 101:925-941. [PMID: 28802471 PMCID: PMC5654539 DOI: 10.1016/j.mcna.2017.04.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Asthma and chronic obstructive pulmonary disease are 2 common chronic respiratory disorders in primary care that cause considerable morbidity and mortality. This article reviews disease pathophysiology and outlines an integrative, multidimensional approach to the evaluation and management of these conditions, including pharmacotreatment, nutrition, supplements, self-care strategies, mind-body therapies, and other integrative modalities.
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Affiliation(s)
- Gloria Y Yeh
- Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, 1309 Beacon Street, Brookline, MA 02446, USA.
| | - Randy Horwitz
- Arizona Center for Integrative Medicine, Department of Medicine, University of Arizona College of Medicine, PO Box 245153, Tucson, AZ 85724-5153, USA
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Engel RM, Wearing J, Gonski P, Vemulpad S. The effect of combining manual therapy with exercise for mild chronic obstructive pulmonary disease: study protocol for a randomised controlled trial. Trials 2017; 18:282. [PMID: 28623944 PMCID: PMC5474053 DOI: 10.1186/s13063-017-2027-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 05/30/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a major cause of disability and hospital admission. Current management strategies have not been successful in altering the loss of lung function typically seen as the disease progresses. A recent systematic review into the use of spinal manipulative therapy (SMT) in the management of COPD concluded that there was low level evidence to support the view that a combination of SMT and exercise had the potential to improve lung function more than exercise alone in people with moderate to severe COPD. The aim of this study is to investigate whether the combination of exercise and manual therapy (MT) that includes SMT produces sustainable improvements in lung function and exercise capacity in people with mild COPD. METHODS/DESIGN The study is a randomised controlled trial of 202 people with stable mild COPD. The cohort will be divided into two equal groups matched at baseline. The first group will receive a standardised exercise program. The second group will receive MT that includes SMT plus the same standardised exercise program. Exercise will be administered a total of 36 times over an 18-week period, while MT will be administered in conjunction with exercise a total of 15 times over a 6-week period. The primary outcome measure is lung function (forced expiratory volume in the 1st second: FEV1 and forced vital capacity: FVC). The secondary outcome measures are the 6-minute walking test (6MWT), quality of life questionnaire (St George's Respiratory Questionnaire: SGRQ), anxiety and depression levels (Hospital Anxiety and Depression Scale: HADS), frequency of exacerbations, chest wall expansion measurements (tape measurements) and systemic inflammatory biomarker levels. Outcome measurements will be taken by blinded assessors on seven occasions over a 48-week period. Adverse event data will also be gathered at the beginning of each intervention session. DISCUSSION This randomised controlled trial is designed to investigate whether the combination of MT and exercise delivers any additional benefits to people with mild COPD compared to exercise alone. The study is designed in response to recommendations from a recent systematic review calling for more research into the effect of MT in the management of COPD. TRIAL REGISTRATION ANZCTRN, 12614000766617 . Registered on 18 July 2014.
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Affiliation(s)
- Roger M. Engel
- Department of Chiropractic, Macquarie University, North Ryde, Sydney, NSW 2109 Australia
| | - Jaxson Wearing
- Department of Chiropractic, Macquarie University, North Ryde, Sydney, NSW 2109 Australia
| | - Peter Gonski
- Southcare, Sutherland Hospital, Sydney, Australia
| | - Subramanyam Vemulpad
- Department of Chiropractic, Macquarie University, North Ryde, Sydney, NSW 2109 Australia
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Nielsen SM, Tarp S, Christensen R, Bliddal H, Klokker L, Henriksen M. The risk associated with spinal manipulation: an overview of reviews. Syst Rev 2017; 6:64. [PMID: 28340595 PMCID: PMC5366149 DOI: 10.1186/s13643-017-0458-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 03/15/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Spinal manipulative therapy (SMT) is a widely used manual treatment, but many reviews exist with conflicting conclusions about the safety of SMT. We performed an overview of reviews to elucidate and quantify the risk of serious adverse events (SAEs) associated with SMT. METHODS We searched five electronic databases from inception to December 8, 2015. We included reviews on any type of studies, patients, and SMT technique. Our primary outcome was SAEs. Quality of the included reviews was assessed using a measurement tool to assess systematic reviews (AMSTAR). Since there were insufficient data for calculating incidence rates of SAEs, we used an alternative approach; the conclusions regarding safety of SMT were extracted for each review, and the communicated opinion were judged by two reviewers independently as safe, harmful, or neutral/unclear. Risk ratios (RRs) of a review communicating that SMT is safe and meeting the requirements for each AMSTAR item, were calculated. RESULTS We identified 283 eligible reviews, but only 118 provided data for synthesis. The most frequently described adverse events (AEs) were stroke, headache, and vertebral artery dissection. Fifty-four reviews (46%) expressed that SMT is safe, 15 (13%) expressed that SMT is harmful, and 49 reviews (42%) were neutral or unclear. Thirteen reviews reported incidence estimates for SAEs, roughly ranging from 1 in 20,000 to 1 in 250,000,000 manipulations. Low methodological quality was present, with a median of 4 of 11 AMSTAR items met (interquartile range, 3 to 6). Reviews meeting the requirements for each of the AMSTAR items (i.e. good internal validity) had a higher chance of expressing that SMT is safe. CONCLUSIONS It is currently not possible to provide an overall conclusion about the safety of SMT; however, the types of SAEs reported can indeed be significant, sustaining that some risk is present. High quality research and consistent reporting of AEs and SAEs are needed. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42015030068 .
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Affiliation(s)
- Sabrina Mai Nielsen
- The Parker Institute, Copenhagen University Hospital, Frederiksberg & Bispebjerg, Frederiksberg, 2000, Denmark
| | - Simon Tarp
- The Parker Institute, Copenhagen University Hospital, Frederiksberg & Bispebjerg, Frederiksberg, 2000, Denmark
| | - Robin Christensen
- The Parker Institute, Copenhagen University Hospital, Frederiksberg & Bispebjerg, Frederiksberg, 2000, Denmark
| | - Henning Bliddal
- Clinical Research Unit, The Parker Institute, Copenhagen University Hospital, Frederiksberg & Bispebjerg, Frederiksberg, 2000, Denmark
| | - Louise Klokker
- The Parker Institute, Copenhagen University Hospital, Frederiksberg & Bispebjerg, Frederiksberg, 2000, Denmark
| | - Marius Henriksen
- Physiotherapy and Biomechanics Research Unit, The Parker Institute, Copenhagen University Hospital, Frederiksberg & Bispebjerg, Frederiksberg, 2000, Denmark.
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Changes in Muscle Spasticity in Patients With Cerebral Palsy After Spinal Manipulation: Case Series. J Chiropr Med 2016; 15:299-304. [PMID: 27857638 DOI: 10.1016/j.jcm.2016.07.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 06/24/2016] [Accepted: 07/31/2016] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE The purpose of this case series was to report quantitative changes in wrist muscle spasticity in children with cerebral palsy after 1 spinal manipulation (SM) and a 2-week course of treatment. METHODS Twenty-nine patients, aged 7 to 18 years, with spastic forms of cerebral palsy and without fixed contracture of the wrist, were evaluated before initiation of treatment, after 1 SM, and at the end of a 2-week course of treatment. Along with daily SM, the program included physical therapy, massage, reflexotherapy, extremity joint mobilization, mechanotherapy, and rehabilitation computer games for 3 to 4 hours' duration. Spasticity of the wrist flexor was measured quantitatively using a Neuroflexor device, which calculates the neural component (NC) of muscle tone, representing true spasticity, and excluding nonneural components, caused by altered muscle properties: elasticity and viscosity. RESULTS Substantial decrease in spasticity was noted in all patient groups after SM. The average NC values decreased by 1.65 newtons (from 7.6 ± 6.2 to 5.9 ± 6.5) after 1 SM. Another slight decrease of 0.5 newtons was noted after a 2-week course of treatment. In the group of patients with minimal spasticity, the decrease in NC after the first SM was almost twofold-from 3.93 ± 2.9 to 2.01 ± 1.0. In cases of moderate spasticity, NC reduction was noted only after the 2-week course of intensive treatment. CONCLUSIONS In this sample of patients with cerebral palsy, a decrease in wrist muscle spasticity was noted after SM. Spasticity reduction was potentiated during the 2-week course of treatment.
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Bordoni B, Marelli F, Morabito B, Sacconi B. Manual evaluation of the diaphragm muscle. Int J Chron Obstruct Pulmon Dis 2016; 11:1949-56. [PMID: 27574419 PMCID: PMC4993263 DOI: 10.2147/copd.s111634] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The respiratory diaphragm is the most important muscle for breathing. It contributes to various processes such as expectoration, vomiting, swallowing, urination, and defecation. It facilitates the venous and lymphatic return and helps viscera located above and below the diaphragm to work properly. Its activity is fundamental in the maintenance of posture and body position changes. It can affect the pain perception and emotional state. Many authors reported on diaphragmatic training by using special instruments, whereas only a few studies focused on manual therapy approaches. To the knowledge of the authors, the existing scientific literature does not exhaustively examines the manual evaluation of the diaphragm in its different portions. A complete evaluation of the diaphragm is mandatory for several professional subjects, such as physiotherapists, osteopaths, and chiropractors not only to elaborate a treatment strategy but also to obtain information on the validity of the training performed on the patient. This article aims to describe a strategy of manual evaluation of the diaphragm, with particular attention to anatomical fundamentals, in order to stimulate further research on this less explored field.
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Affiliation(s)
- Bruno Bordoni
- Department of Cardiology, Foundation Don Carlo Gnocchi IRCCS, Institute of Hospitalization and Care with Scientific Address, Milan; CRESO, School of Osteopathic Centre for Research and Studies, Castellanza; CRESO, School of Osteopathic Centre for Research and Studies, Falconara Marittima
| | - F Marelli
- CRESO, School of Osteopathic Centre for Research and Studies, Castellanza; CRESO, School of Osteopathic Centre for Research and Studies, Falconara Marittima
| | - B Morabito
- CRESO, School of Osteopathic Centre for Research and Studies, Castellanza; CRESO, School of Osteopathic Centre for Research and Studies, Falconara Marittima; Foundation Polyclinic University A Gemelli, University Cattolica del Sacro Cuore
| | - B Sacconi
- Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Rome, Italy
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